J Formos Med Assoc
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When a bleeding source from the gastrointestinal (GI) tract cannot be identified with conventional diagnostic studies, it is known as GI bleeding of an obscure origin. In the past three years, in vivo Technetium 99m-labeled red blood cell scintigraphy (RBC scan) has been added to our armamentarium for the diagnosis of obscure GI bleeding. Out of a total of 26 cases, the bleeders could be detected in 12 or 46.2% by RBC scan. ⋯ False localization could be prevented by shortening the sequential imaging interval. It is concluded that an RBC scan is a very sensitive and safe tool for detection of GI bleeding of an intermittent nature, because the bleeder can be monitored for 24 hours after a single injection. It can be used as a preangiographic screening test and to guide the surgeon in surgical planning or decision-making.(ABSTRACT TRUNCATED AT 250 WORDS)
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The purpose of this series is to prospectively validate the Chinese equations for predicting fetal weight developed in a previous study. A total of 640 Chinese fetuses were examined antenatally for biparietal diameter (BPD), abdominal circumference (AC) and femur length (FL) by real-time ultrasonography within two days of delivery. ⋯ Our results demonstrate that the Chinese equations developed by Hsieh et al are a better fit for Chinese fetuses than the foreign equations are. Also, the two Chinese equations predict fetal weight well between 2,000 g and 4,000 g, but further modification is needed in cases where the BW is less than 2,000 g or greater than 4,000 g.
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In order to provide better quality of care at Taipei Veterans General Hospital, 13,911 emergency patients coming into the medical emergency room were studied using the computer to key in all demographic data including registration time, time to be seen, desposition time, impression, triage category, discipline as well as daily dynamic status in the observation room from August through December 1989. The study showed that 8.6% were triage category 1 (life-threatening cases) and 22.08% were triage 4 (pseudo-emergency patients). ⋯ In general, the daily dynamic status of the patients in the observation room were: (1) Out of 45 overnight patients, 12 (27%) were waiting for admission; and (2) 9 (20.14%) were waiting for a transfer to other convalescent hospitals. We conclude that less than one-tenth of the emergency patients were really emergencies in such a large and busy emergency department, and there was enormous patients stasis in the observation room causing overcrowding of the emergency department, which is the main issue we have to resolve if the quality assurance of the emergency department is to be improved.
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Comparative Study
Ethnic comparison of haloperidol and reduced haloperidol plasma levels: Taiwan Chinese versus American non-Chinese.
Steady-state haloperidol (HAL) and reduced HAL (RHAL) plasma levels were measured in Chinese and non-Chinese schizophrenic patients. The patients (n = 38) were matched according to age (+/- 1 yr) and by HAL dose. In general, Chinese patients had higher mean plasma HAL levels and lower RHAL/HAL ratios compared to non-Chinese patients (23.6 +/- 14.9 ng/ml versus 17.1 +/- 10.1 ng/ml, p less than 0.05; 0.52 +/- 0.44 versus 0.82 +/- 0.62, p less than 0.05). ⋯ RHAL/HAL ratios were generally lower in the Chinese patients than in the non-Chinese patients, with a strong trend toward the significance level in the 20 mg and 30 mg groups (0.22 +/- 0.13 versus 0.58 +/- 0.57, p = 0.066 and 0.43 +/- 0.26 versus 0.71 +/- 0.34, p = 0.062). This study further suggests the possibility of different metabolic rates between Chinese and non-Chinese patients. Possible differences in the enzyme systems which relate to the metabolism of HAL and RHAL between Chinese and non-Chinese populations are discussed.
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Comparative Study
The prognostic value of blood glucose in patients with acute stroke.
We prospectively studied levels of blood glucose and glycohemoglobin, and their correlations with types, severity, and prognosis of stroke in 37 patients with brain infarction (BI) and 35 patients with brain hemorrhage (BH). We found that in the BH group, patients with an elevated glucose level due to stress, diabetes, or both, had a lower consciousness level on admission, larger hematoma size, higher incidence of rupture into the ventricles, and a worse 1-month outcome than patients with a normal glucose level (p less than 0.05). ⋯ However, it seems to be the severity of the stroke, not the hyperglycemia, that causes the poor outcome. Hyperglycemia may be an epiphenomenon of stroke severity.